ABSTRACT
Objective To evaluate the prognostic value of fluorodeoxyglucose (FDG) standardized uptake value (SUV) of positron emission tomography (PET) before radiotherapy in non-small cell lung cancer (NSCLC) treated with three-dimensional conformal radiation therapy (3DCRT). Methods Seventy-three patients with stage Ⅲ NSCLC underwent PET to calculate SUV within 2 weeks before 3DCRT. The a-nalysis was carried out after the irradiation of 60 -66 Gy. The possible prognostic factors were assessed by Cox proportional hazards model. Results The mean SUV for squamous cell carcinoma, adenocarcinoma and others were 16.94, 14.40 and 6.33, respectively (F = 0. 51, P = 0. 604). The mean SUV for tumor volume less than and more than 50 cm~3 was 13.81 and 20.18 (F = 7.54, P = 0. 008). In the univariate analysis, a cutoff SUV of 17 and chemotherapy were correlated with the prognosis. In the multivariate analysis, SUV was the only independent prognostic factor (relative risk = 2.61). Conclusions SUV is a prognostic factor in patients with NSCLC treated by 3DCRT, which deserves further studies.
ABSTRACT
Purpose:To investigate the clinical applicati on and curative effect of salvage treatment for primary recurrence after definitiv e radiotherapy in patients with laryngeal cancer. Methods:52 patients with laryngeal cancer receiving definitive radiotherapy in the Cancer Center of Sun Yat-sen University between 1990 and 19 95 were reviewed retrospectively. Among them, 17 patients presented with primary recurrence. Salvage treatment after radiotherapy failure included palliative ch emotherapy (5 cases) and surgical salvage (12 cases). 6 patients were salvaged b y partial laryngectomy and 6 patients by total laryngectomy. SPSS 10.0 software was used to analyze the effects, complications and the differences between diffe rent salvage treatments. Results:The overall 3- and 5-year cumulative survival rates a fter salvage treatment for primary recurrence in patients with laryngeal cancer receiving definitive radiotherapy were 56.3% and 37.5% respectively. The patient s receiving palliative chemotherapy after radiotherapy failure survived between 8 and 26 months. The 3- and 5-year cumulative survival rate in patients receiv ing surgical salvage were 75% and 50% respectively. There was significant differ ence between them analyzed by Kaplan-Meier (Log Rank=8.14, P=0.004 3). More over, the 5-year survival rates in patients salvaged by partial laryngectomy an d total laryngectomy were all 50% and there was no statistical difference betwee n them (Log Rank=0.08, P=0.7782). 5 out of 12 (41.7%) patients salvaged by s urgery presented complication after surgery, mainly infection after surgery (25 %) and pharyngocutaneous fistula (25%). Conclusions:Surgical salvage for primary recurrence in patients with laryngeal cancer receiving definitive radiotherapy could be effective.Part ial laryngectomy could be used for early primary lesion (T 1 and T 2) in patie nts with primary recurrence. The complications after salvage surgery were mainly were infection and pharyngocutaneous fistula.